THEY IMPLY A PHASE OF DECEPTION, so far as a formal "consent" is ever obtained without a full and complete statemnet of possible dangers. Can we imagine Mary Rafferty to have consented to Bartholow's experiments upon her brain, if, in full possession of her intellectual faculties, she had known—as he knew,—what risks they involved? It is the performance of experiments upon dying children, upon infants for no urpose of individual benefit, upon men and women all unconscious of the character of the investigation; the imposition upon the ignorant and confiding of unknown risks; the utilization for experimentation under cover of treatment for their ailments, of the poor, the feeble- minded, the unfortunate, without their full, intelligent and adequate consent, that makes the practice abhorrent to every conception of morality, and every ideal of honour.
How such experiments are coming to be regarded, we may see in a recent article from the pen of Dr. Francis H. Rowley, president of the Massachusetts Society for the Prevention of Cruelty to Animals:
"The use of children in hospitals, or anywhere else, as material for experimentation is not to be tolerated for a moment, in our judgment, by any right-minded man or woman. Whatever is conscientiously done for the benefit of the child itself, to save it from disease or to lessen its suffering, though it may cause it temporarily more or less pain, is nothing against which objection should be made. But to use the child, even when no permanent harm may result to it, as a subject upon which to try out certain theories, or to test the efficacy of certain drugs, so long as this is not absolutely for the good of the individual child treated rather than for children in general, is abhorrent to the most of us. To cause a helpless baby one hour's distress, to say nothing of suffering, for the sake even of other children, when that baby has been brought to the hospital by its parents or guardians solely for what may be done for its benefit, we hold to be a breach of trust on the part of hospital authorities and physicians that hasn't the slightest defence either in morals or in law.
"We write these words not because we believe that any physician is so far fallen below the lowest levels of our common humanity as to inject into a defenceless child the active germs of a loathsome or possibly fatal disease, but because our moral sense is outraged at any treatment of the child such as we should refuse to permit were the child our own. We believe he universal assertial of parents would be that, if having taken their child to a hospital for tratment, they learned that it had beenused for experimentation, though no lasting harm could come to it from the experiment, someone would pay the penalty for the unwarranted deed, if money or influence or, these failing, muscle, could reach far enough to find the offender."
Does such condemnation of experimentation upon the hospital patient or children tend to block scientific advance? Not at all. A recent writer tells us that "once it is evident that man himself must be the experimental animal, the scientist volunteer is always ready." If this be so, why should not the human "material" be acquired always in a way to which the charge of unjust procedure would never be applicable? If assurance could have been given that the luetin test implied no risk of any kind, might not the Rockefeller Institute have secured any number of volunteers by the offer of a gratuity of twenty or thirty dollars as a compensation for any discomfort that might be endured? Of the thousands of medical students in the State of New York, are there not hundreds who would have offered with eagerness to submit to a test devoid of peril, in the interests of scientific research? And even if an experiment implied danger, might there not be sufficient compensation for all risks? Every year firemen lose their lives in the flames, and policemen are murdered. The compensation they receive induces them to incur risks that might not otherwise be assumed. A great theologian is said to have affirmed that a man, perishing from starvation, had the moral right to take a loaf of bread that did not belong to him, if only thus he could preserve his life. Is Science ever in such straits of necessity that in a single instance it is obliged to take from any man his supreme right of inviolability, and to make its experiments within the wards of the hospital, upon the eyes of the dying, upon the bodies of the ignorant and the poor?
There is yet another method by which perhaps we may test the morality of the practice. A great philosopher of another century seeking to find some criterion of man's duty toward his fellow-men, based obligation upon a universal law. "Act," said Kant, "as if the motive of thy conduct were to become by thy will a universal law." Suppose we apply this maxim of Kant to the use of human beings for research purposes. An experimenter in a hospital makes dying children his material. Is he willing that the maxim of his act should be universal, and apply to experiments upon his own child, when it lies at the point of death? He plunges needle-electrodes into the brain of a simple-minded and perhaps friendless servant-girl. Can we imagine him willing that the motive of his deed should govern and justify experiments of the same kind made upon his mother or his wife? Following Ringer, he tests the actions of poisons upon patients in some hospital under his control. Would he be willing that the law be universal, and that the action of such drugs should first be tested upon himself? He suggests the use of healthy children as "controls" in tests with the dead germs of a horrible disease. Is there anyone connected with the Rockefeller Institute, for example, who would be willing that such act should establish a universal precedent, and that his own children should be taken, and without his knowledge, made the "material" for such research?
Admitting that some experiments upon human being may be ethically permissible, and that other phases of such investigations are morally wrong, how are we to distinguish between them? May it not be possible to indicate principles which would be generally accepted, according to which the line may be drawn? Let us make the attempt.
I. Justifiable Experimentation upon Man
1. All experiments made by intelligent and conscientious physicians or surgeons upon their patients for some definite purpose pertaining to the personal benefit of the patient himself, and when practicable, in case of risk, with his or her consent. (This rule is intended to include every possible experiment made by a medical practitioner for the benefit of the patient, with a distinct ameliorative purpose in view.)
2. All experiments made with an intelligent purpose by a scientific man or medical practitioner upon himself.